Large Spot Laser for Treatment of Retinopathy of Prematurity

BACKGROUND AND OBJECTIVE: To compare large spot versus standard spot laser for treatment of retinopathy of prematurity (ROP). PATIENTS AND METHODS: Eighty eyes of 40 infants with bilateral type 1 ROP were randomized for laser photocoagulation using laser indirect ophthalmoscope with either standard spot or large spot size laser. During the procedure, total time taken and Premature Infant Pain Profile (PIPP) scores were noted. Regression of disease and refractive error were noted on follow-up. RESULTS: The infants were randomized into two groups. All infants in both groups had regression of ROP. Large spot laser significantly reduced total treatment duration in zone I by 32% (P = .005) and zone II by 63.4% (P = .0006). Moderate-to-severe pain occurred in PIPP scores in both groups throughout the procedure (under topical anesthesia) and was comparable between the groups. Mean change in refractive error (myopia) from pre-laser (2.090 diopters [D] ± 1.345 D) to 3 months' post-laser (2.465 D ± 1.399 D) was not statistically significant between the groups. CONCLUSIONS: Large spot laser significantly reduced total duration of laser treatment in zone I/II ROP. Large spot laser is a useful alternative for treatment of ROP in terms of faster procedure, lesser total duration of pain, and similar regression profile. It does not cause additional myopia and can be performed without additional training. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e233-e239.].